F&N Bulletin Vol 23 No 1b - United Nations University

46
E-S. Tee et al.
TABLE 7. Prevalence of undernutrition among urban and rural primary schoolchildren
Height-for-age Weight-for-age Weight-for-height
Children n < –2 SD (%) n < –2 SD (%) n < –2 SD (%)
Urban
Boys 3,033 8.1 3,035 7.9 2,937 4.8
Girls 2,952 5.6 2,958 6.8 2,036 4.5
Both sexes 5,985 6.9 5,993 7.4 4,973 4.6
Rural a
Boys 1,049 34.4 1,057 29.1 950 8.2
Girls 1,066 24.9 1,069 26.1 731 6.2
Both sexes 2,115 29.6 2,126 26.9 1,681 7.3
Rural and urban
Boys 4,082 4.4 4,092 3.7 3,887 1.7
Girls 4,018 4.5 4,027 4.1 2,767 1.4
Both sexes 8,100 4.4 8,119 3.8 6,654 1.6
a. Data from World Health Organization [2].
schoolchildren (1.9%) [3] (table 8). The prevalence of
overweight among rural boys and girls was approximately
the same at 2.0%. On the other hand, the
prevalence of overweight among urban boys was about
twice that among urban girls.
Conclusions
The mean weights and heights of boys were greater
than those of girls for the younger age groups (7 and
8 years). As the ages increased (9 and 10 years), the
reverse was true and the girls were heavier and taller
than the boys. The mean BMI was generally greater for
boys in all age groups. Undernutrition, as determined
by the prevalences of stunting, underweight, and wasting,
was also more serious among the boys, particularly
as measured by stunting and underweight.
The prevalence of overweight was higher than that
of wasting for both boys and girls in all age groups.
Boys had a slightly higher prevalence of overweight
TABLE 8. Prevalence of overweight among urban and rural
schoolchildren
Children n > 2 SD (%)
Urban
Boys 2,937 9.5
Girls 2,036 5.2
Both sexes 4,973 7.7
Rural a
Boys 1,731 2.0
Girls 1,544 1.9
Both 3,275 1.9
Urban and rural
Boys 4,668 4.8
Girls 3,580 2.7
Both sexes 8,248 4.1
a. Data from World Health Organization [2].
than girls; the difference was larger for the older
children. Both undernutrition and overweight were
more frequent among boys. The prevalence of undernutrition
among the urban study subjects (less than
8%) was much less than that among rural primary
schoolchildren. On the other hand, the prevalence of
overweight (about 8%) was much greater than among
rural children (about 2%). The factors responsible for
this difference in nutrition between rural and urban
children should be investigated to provide useful lessons
for the prevention and control of overweight.
The analysis of weight and height measurements in
this study was complicated by the fact that the study
subjects ranged from 7 to 10 years old, consisting of
younger primary schoolchildren in the prepuberty age
group. As is well known, the NCHS data in the Anthro
program are not appropriate for analyzing children
over 9 years of age. The results of investigations into
the use of weight-for-height Z score and BMI-for-age
for the determination of thinness and overweight have
been discussed earlier.
The analyses suggested that the use of cutoff points
of less than the 5th percentile and equal to or greater
than the 85th percentile for determining the prevalences
of thinness and overweight, respectively, as
recommended by WHO [2], may not be appropriate.
These indicators appeared to have overestimated the
prevalences by a magnitude of about two to three.
To overcome the problem for overweight, the cutoff
was set at at or above the 95th percentile, and the
figures obtained are felt to be more realistic. The use
of less than the 3rd percentile of the reference data
for underweight would probably give prevalence data
closer to those obtained by using the weight-for-height
Z score.
It is important to determine whether these findings
of differences in prevalences of thinness and overweight
using the two methods of analysis are observed
for other communities. It may be necessary to change